Concept: Dialysis Treatment Start and Dialysis Treatment End

Introduction

This concept defines dialysis and describes how the start and end (exit) of this treatment are defined in the Care of Manitobans Living with Chronic Kidney Disease deliverable by Chartier et al. (2015). This includes the age groups applied, the data sources for this definition, the code values and conditions identifying dialysis treatment, and any additional conditions / restrictions that are applied.

Dialysis is defined as a treatment for people in the end stage of chronic renal insufficiency (kidney failure). This treatment cleans the blood and removes wastes and excess water from the body (Martens et al. 2010).

Technical Definition of Dialysis Treatment Start and Dialysis Treatment End

The following describes how the start and end of dialysis treatment are defined and identified in Chartier et al. (2015).

Dialysis Treatment Start

The technical definition for starting dialysis treatment that was defined in Chartier et al. (2015) is as follows:


• Age Groups:
  
  • Children: 0-17 years old
    
  • Adults: 18 years and older
  
  
• Data Sources:
  
  • Medical Services (Physician Claims) data; and the
    
  • Manitoba Renal Program (MRP) data.
  
  
• Code Values and Conditions: - defined as the first dialysis session of Manitoba residents in April 1, 1999 – March 31, 2012 where:
  
  
  • dialysis continues for 90 days or until death with no gaps > 15 days between sessions (physician tariffs: 3792, 3790, 3793, 3794, 3800, 3801, 3803, 3804, 3805, 9610, 9798, 9799, 9801, 9802, 9805, 9806, 9807, 9814, 9819, 9820, 9821) from the Medical Services data.
  
  
• Conditions / Restrictions:
  
  • Dialysis starts before January 1, 2004 were identified using physician claims. Dialysis starts on January 1, 2004, or later were identified using the Manitoba Renal Program data.

Dialysis Treatment End

The technical definition of ending dialysis treatment that was defined in Chartier et al. (2015) is as follows:


• Age Groups:
  
  • Children: 0-17 years old
    
  • Adults: 18 years and older
  
  
• Data Sources:
  
  • Medical Services (Physician Claims) data
    
  • Manitoba Health Insurance Registry Data; and the
    
  • Hospital Abstracts data.
  
  
• Code Values and Conditions: - defined as Manitoba residents with:
  
  
  • at least 180 days has elapsed since the last physician claim for dialysis (physician claim tariffs: 3792, 3790, 3793, 3794, 3800, 3801, 3803, 3804, 3805, 9610, 9798, 9799, 9801, 9802, 9805, 9806, 9807, 9814, 9819, 9820, 9821) from the Medical services data; or
    
  • at least 1 physician claim for kidney transplant (ICD-9-CM procedure: 55.6; tariff: 5883) from the Hospital Abstracts data or the Medical Services data; or
    
  • at least 1 hospitalization for kidney transplant (ICD-10-CA intervention: 1PC349, 1OK85) from the Hospital Abstracts data; or
    
  • death or end of health insurance coverage in the Health Insurance Registry data.